title: A five-drug alternating chemotherapy regimen for patients with advanced epithelial ovarian cancer.
abstract: Twenty-six patients, 22 previously untreated, with FIGO stage III/IV epithelial ovarian cancer were treated with a five-drug combination regimen consisting of cycles of cisplatinum (60 or 75 mg/m2 IV) and cyclophosphamide (600 or 750 mg/m2 IV) [CP], alternating every 3 weeks with cycles of adriamycin [50 mg/m2 IV], bleomycin [15 mg IV], and chlorambucil [6 mg/m2 orally for 7 days] [ABC]. A total of six cycles, CP x 3 and ABC x 3, were planned. There was a 67% response rate with 7 complete and 5 partial remissions in 18 patients with evaluable disease. Median progression-free interval was 13 months and median survival 24 months for the whole group. The regimen was well tolerated with WHO toxicity greater than 2 in only 5 patients and treatment delay occurring in only 18 of 128 cycles [14%] in 11 patients. The toxicity of combination cytotoxic regimens can be reduced by alternating cycles of therapy. A randomized trial comparing such a regimen with nonalternating therapy would be necessary to determine whether the response rate and duration of response are compromised when the cumulative dose of cisplatinum is reduced.
authors.affiliation: Academic Department of Obstetrics and Gynaecology, University of Birmingham, United Kingdom.
authors.forename: F
authors.initials: F
authors.lastname: Lawton
authors.forename: C
authors.initials: C
authors.lastname: Meanwell
authors.forename: J
authors.initials: J
authors.lastname: Mould
authors.forename: G
authors.initials: G
authors.lastname: Blackledge
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000627:therapeutic use; D002277:Carcinoma / Q000188:drug therapy* / Q000401:mortality; D002945:Cisplatin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D004351:Drug Resistance; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000401:mortality; D015996:Survival Rate; D013997:Time Factors
chemical_list: D002945:Cisplatin